Module 3: Staff Empowerment

AHRQ Safety Program for Long-Term Care: HAIs/CAUTI

Slide 1: Module 3: Staff Empowerment

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Slide 2: Objectives

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  • Cite staff empowerment concepts.
  • Discuss how staff empowerment contributes to a culture of resident safety, leading to improved outcomes and quality of life.
  • Illustrate three ways to increase staff empowerment.
  • Explain how to address and overcome challenges to staff empowerment.

Slide 3: What Is Staff Empowerment?

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  • Ability to independently make decisions.
  • "Access to support, resources, information, and opportunities to learn and grow".1

Slide 4: Organizational Factors for Staff Empowerment2-4

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  • Structures for advancement opportunities.
  • Awareness of staff contributions.
  • Access to resources, information, and support.

Image: Staff looking at a table

2. Brannon D, Mor V. Nurse aide empowerment strategies and staff stability: Effects on nursing home resident outcomes. The Gerontologist. 2005;45(3):309-317.
3. Bowers N, Nolet K, Roberts E, et al. Implementing Change in Long-Term Care: A Practical Guide to Transformation. University of Wisconsin–Madison, School of Nursing; 2007.
4. Cready C, Yeatts D, Gosdin M, et al. CNA empowerment: Effects On Job Performance And Work Attitudes. Journal of Gerontological Nursing. 2008;34(3):26-35.

Slide 5: Staff Empowerment Assessment Tools3,5

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HHS Report - Measuring Long-Term Care Work: A Guide to Selected Instruments to Examine Direct Care Worker Experiences and Outcomes

  • Conditions for Work Effectiveness Questionnaire.
  • Perception of Empowerment Instrument (PEI).
  • Psychological Empowerment Instrument.
  • Yeatts and Cready Dimensions of Empowerment Measure.

3. Bowers N, Nolet K, Roberts E, et al. Implementing Change in Long-Term Care: A Practical Guide to Transformation. University of Wisconsin–Madison, School of Nursing; 2007.
5. Harris-Kojetin L, Brannon D, Barry T, et al. Measuring Long-Term Care Work: A Guide to Selected Instruments To Examine Direct Care Worker Experiences and Outcomes. Washington, D.C.: U.S. Department of Health & Human Services, U.S. Department of Labor; 2005.

Slide 6: Psychological Empowerment Instrument5

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Sample questions for measuring competence:

How strongly do you agree or disagree with these statements?

  1. I am confident about my ability to do my job.
  2. I am self-assured about my capability to perform my work.
  3. I have mastered the skills necessary for my job.

5. Harris-Kojetin L, Brannon D, Barry T, et al. Measuring Long-Term Care Work: A Guide to Selected Instruments To Examine Direct Care Worker Experiences and Outcomes. Washington, D.C.: U.S. Department of Health & Human Services, U.S. Department of Labor; 2005.

Slide 7: Why is Staff Empowerment Important?5,6

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  • Higher staff satisfaction.
  • Lower turnover.
  • Improved quality of care for residents.

Image: Staff with a resident in a wheelchair

5. Harris-Kojetin L, Brannon D, Barry T, et al. Measuring Long-Term Care Work: A Guide to Selected Instruments To Examine Direct Care Worker Experiences and Outcomes. Washington, D.C.: U.S. Department of Health & Human Services, U.S. Department of Labor; 2005.
6. Kolus K. Mather Pavilion – Staff Empowerment Yields Quality Improvement. Long-Term Living. 2010;59(9):20.

Slide 8: Relationship Between Resident Quality of Life and Staff Empowerment7

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Image: Increased staff empowerment leads to increased job satisfaction and lower job turnover, which in turn leads to increased resident satisfaction and perception of care, resulting in a higher quality of care overall.

7. Hamann DJ. Does Empowering Resident Families or Nursing Home Employees in Decision Making Improve Service Quality? Journal of Applied Gerontology. 2014;33(5):603-23

Slide 9: Importance of Empowering Nursing Staff4,7

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  • Frontline providers.
  • Increased flow of information.
  • Resident advocates.

Image: Staff walking

4. Cready C, Yeatts D, Gosdin M, et al. CNA empowerment: Effects On Job Performance And Work Attitudes. Journal of Gerontological Nursing. 2008;34(3):26-35.
7. Hamann DJ. Does Empowering Resident Families or Nursing Home Employees in Decision Making Improve Service Quality? Journal of Applied Gerontology. 2014;33(5):603-23

Slide 10: Characteristics of an Empowered Frontline Staff

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  • Curiosity.
  • Interest in improvement.
  • Knowledge of nursing home resources and infrastructure.

Image: Nursing reviewing charts

Slide 11: Curiosity

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  • Understand changes and the reasoning behind them.
  • Increase their knowledge about clinical care areas.
  • Have numerous opportunities to learn about how the organization operates and how resources are allocated.

Slide 12: Interest in Improvement

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  • Understand how to apply and be actively involved in implementing best practices at an individual resident level.
  • Understand how best practices can be implemented and supported at a unit and facility level.

Image: Staff at a table

Slide 13: Knowledge of Nursing Home Resources and Infrastructure

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  • Assessment of organizational processes.
  • Evaluation of practice interventions.
  • Active participation in continuous assessment and evaluation.

Slide 14: What Builds Staff Empowerment?

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  • Leader support and teams.
  • Communication and information sharing.
  • Positive reinforcement.
  • Confidence.
  • Just Culture.

Image: A group of staff

Slide 15: An Empowered Team

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Image: Indicating a video on the slide

PLAY VIDEO:
Video 2.2: Enabling the Team

Slide 16: Leader Support and Teams2,4

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  • Teamwork
  • Resources
    • Channels for advancement or growth in the organization.
    • Opportunity for increases in knowledge and skill.
    • Ability to participate in task forces or committees.

2. Brannon D, Mor V. Nurse aide empowerment strategies and staff stability: Effects on nursing home resident outcomes. The Gerontologist. 2005;45(3):309-317.
4. Cready C, Yeatts D, Gosdin M, et al. CNA empowerment: Effects On Job Performance And Work Attitudes. Journal of Gerontological Nursing. 2008;34(3):26-35.

Slide 17: Teamwork and Support

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Image: Indicating a video on the slide

PLAY VIDEO
Video 3.1 Teamwork and Support

Slide 18: Communication and Information Sharing3

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  • Encourage two-way communication between management and staff.
  • Provide a clear venue for all staff to share their achievements.
  • Create procedures for staff to safely share concerns.

Image: Unclear communication between staff

3. Bowers N, Nolet K, Roberts E, et al. Implementing Change in Long-Term Care: A Practical Guide to Transformation. University of Wisconsin–Madison, School of Nursing; 2007.

Slide 19: Open Communication

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Image: Indicating a video on the slide

PLAY VIDEO
Video 3.2 Open Communication

Slide 20: Positive Reinforcement3

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  • Recognize staff and their contributions.
  • Celebrate success.
  • Use Learn From Defects tool.

Image: Staff shaking hands

3. Bowers N, Nolet K, Roberts E, et al. Implementing Change in Long-Term Care: A Practical Guide to Transformation. University of Wisconsin–Madison, School of Nursing; 2007.

Slide 21: Positive Reinforcement

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Image: Indicating a video on the slide

PLAY VIDEO
Video 3.3 Positive Reinforcement

Slide 22: Confidence9

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  • Collaborative trust and confidence.
  • Psychological safety
    • Invite input from all team members.
    • Encourage team members to contribute.
    • Promote active listening and learning from each other.
    • Ensure all team members are accessible.
    • Acknowledge the limits of current knowledge.

9. CUSP Toolkit. Rockville, MD: Agency for Healthcare Research and Quality; December 2012.

Slide 23: Collaborative Trust and Confidence

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Image: Indicating a video on the slide

PLAY VIDEO
Video 3.4 Collaborative Trust and Confidence

Slide 24: Just Culture8,9

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  • Mission, values, and expectations.
  • System design.
  • Managing behavioral choices.
  • Learning systems.
  • Accountability and justice
    • Philosophy for response to error.

8. Griffith S. Just Culture, Healthcare Services Overview. Outcome Engineering; 2012.
9. CUSP Toolkit. Rockville, MD: Agency for Healthcare Research and Quality; December 2012.

Slide 25: A Just Culture

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Image: Indicating a video on the slide

PLAY VIDEO
Video 3.5: Just Culture and Open Communication

Slide 26: Barriers to Staff Empowerment10

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  • Lack of senior leader support.
  • Lack of resources.
  • Poor teamwork and support.
  • Stagnation and loss of momentum for change.
  • Staff turnover.
  • Punitive response to error.

10. TeamSTEPPS Long-Term Care Toolkit. Rockville, MD. Agency for Healthcare Research and Quality; October 2012.

Slide 27: Key Concepts Review

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  • Empowerment of frontline staff contributes to lower staff turnover and higher job satisfaction, which increases resident satisfaction and safety.
  • Key factors influencing an empowered staff
    • Structures for advancement opportunities.
    • Awareness of staff contributions.
    • Access to resources, information, and support.

Slide 28: References

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  1. Laschinger, HKS and Read, E. The influence of nursing unit empowerment and social capital on unit effectiveness and nurse perceptions of patient care quality. Journal of Nursing Administration. 2014;44(6):347-352.
  2. Brannon D, Mor V. Nurse aide empowerment strategies and staff stability: Effects on nursing home resident outcomes. The Gerontologist. 2005;45(3):309-317.
  3. Bowers N, Nolet K, Roberts E, et al. Implementing Change in Long-Term Care: A Practical Guide to Transformation. University of Wisconsin–Madison, School of Nursing; 2007.
  4. Cready C, Yeatts D, Gosdin M, et al. CNA empowerment: Effects On Job Performance And Work Attitudes. Journal of Gerontological Nursing. 2008;34(3):26-35.
  5. Harris-Kojetin L, Brannon D, Barry T, et al. Measuring Long-Term Care Work: A Guide to Selected Instruments To Examine Direct Care Worker Experiences and Outcomes. Washington, D.C.: U.S. Department of Health & Human Services, U.S. Department of Labor; 2005.

Slide 29: References

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  1. Kolus K. Mather Pavilion – Staff Empowerment Yields Quality Improvement. Long-Term Living. 2010;59(9):20.
  2. Hamann DJ. Does Empowering Resident Families or Nursing Home Employees in Decision Making Improve Service Quality? Journal of Applied Gerontology. 2014;33(5):603-23
  3. Griffith S. Just Culture, Healthcare Services Overview. Outcome Engineering; 2012.
  4. CUSP Toolkit. Rockville, MD: Agency for Healthcare Research and Quality; December 2012. 
  5. TeamSTEPPS Long-Term Care Toolkit. Rockville, MD. Agency for Healthcare Research and Quality; October 2012.
Page last reviewed March 2017
Page originally created March 2017
Internet Citation: Module 3: Staff Empowerment. Content last reviewed March 2017. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/implementation/long-term-modules/module3/mod3-slides.html